1
|
Berihun GA, Tesfaye G, Adissu W, Tadasa E, Adamu K, Kombe AT, Gedefaw L. Prevalence and Associated Factors of Anemia among Newborns at Jimma Medical Center, South-west Ethiopia. J Blood Med 2024; 15:129-140. [PMID: 38510843 PMCID: PMC10950678 DOI: 10.2147/jbm.s443312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 03/01/2024] [Indexed: 03/22/2024] Open
Abstract
Background Newborn anemia is among the most common hematological problems and it can cause asymptomatic or severe to acute life-threatening events. It leads to impairment in brain maturation and development, tissue hypoxia, and stunted growth and then arrested growth if left untreated. The prevalence of anemia among newborns ranges from 23.4-66% in sub-Saharan Africa. But, there is limited information in Ethiopia regarding the prevalence of newborn anemia and its risk factors. Therefore, this study aimed to determine the prevalence of newborn anemia and its associated factors at Jimma Medical Center (JMC), South-west Ethiopia. Methods A hospital-based cross-sectional study design was implemented from January 14 to February 28, 2021, involving 288 full-term newborns by employing consecutive convenient sampling technique for study participant selection. Socio-demographic data and other associated factors were collected through interviews and a review of medical records by a structured questionnaire. Three mL umbilical cord blood samples from each newborn were collected and analyzed for a complete blood count by an automated hematological analyzer. Data were entered into Epi Data version 3.1 and exported to Statistical Package for Social Science version 20 for analysis. Binary logistic regression were used to identify the predictors of newborn anemia. Results The overall prevalence of anemia among newborns was 26.4%; of them, 65.8%, 25%, and 9.2% were mild, moderate, and severe anemia types, respectively. Maternal vegetable consumption habit (AOR = 0.26, 95% CI: 0.11, 0.62) and maternal anemia (AOR = 0.34, 95% CI: 0.17, 0.69) were significantly associated with anemia in newborns. Conclusion In general, newborn anemia in this study was a moderate public health problem. Based on this study, early screening of anemia among newborns may reduce further complications. Prevention of maternal anemia during pregnancy by improving their nutritional status especially vegetable consumption had a positive impact on reducing anemia among newborns.
Collapse
Affiliation(s)
- Gebeyaw Arega Berihun
- School of Medical Laboratory Sciences, Faculty of Health Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Girum Tesfaye
- School of Medical Laboratory Sciences, Faculty of Health Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Wondimagegn Adissu
- School of Medical Laboratory Sciences, Faculty of Health Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Edosa Tadasa
- School of Medical Laboratory Sciences, Faculty of Health Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Kidist Adamu
- Department of Health Policy and Management, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Abinet Tantu Kombe
- School of Medical Laboratory Sciences, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Lealem Gedefaw
- School of Medical Laboratory Sciences, Faculty of Health Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| |
Collapse
|
2
|
Ahmed I, Elmugabil A, Adam I, Almohaimeed A. The association between female newborn and placental malaria infection: A case-control study. Placenta 2023; 138:55-59. [PMID: 37196581 DOI: 10.1016/j.placenta.2023.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 04/15/2023] [Accepted: 05/04/2023] [Indexed: 05/19/2023]
Abstract
INTRODUCTION There are few published data on the influence of the sex of the fetus or the newborn on the rate of malaria infection. Moreover, the results of these studies are not conclusive. This study was conducted to investigate the association between sex of the newborn and placental malaria infection. METHODS A case-control study was conducted at Al Jabalian maternity hospital in central Sudan during the rainy and post rainy seasons from May to December 2020. The cases were women who had placental malaria, while the controls were subsequent women who had no placental malaria. A questionnaire was filled out by each woman in the case and control groups in order to gather demographic data as well as medical and obstetric history. Malaria was diagnosed using blood films. Logistic regression analyses were performed. RESULTS There were 678 women in each arm of the study. Compared with the women without placental malaria (controls), women with placental malaria had a significantly lower age and parity. A significantly higher number of the cases had delivered female newborns, 453 (66.8%) vs. 208 (30.7%), P < 0.001. In logistic regression, women with placental malaria: lived in rural areas, had low antenatal attendance, did not use bed nets, and had more female newborns (adjusted odds ratio, AOR = 2.90, 95% CI = 2.08-4.04). DISCUSSION Women who delivered female were more likely to have placental malaria. Further research into the immunologic and biochemical parameters is warranted.
Collapse
Affiliation(s)
- Itedal Ahmed
- Department of Anatomy, Najran University, Saudi Arabia; Faculty of Medicine, Gezira University, Sudan.
| | | | - Ishag Adam
- Department of Obstetrics and Gynecology, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Saudi Arabia.
| | - Amani Almohaimeed
- Department of Statistic and Operation Research, College of Sciences, Qassim University, Buraydah, Saudi Arabia.
| |
Collapse
|
3
|
Banda CG, Nkosi D, Allen E, Workman L, Madanitsa M, Chirwa M, Kapulula M, Muyaya S, Munharo S, Tarning J, Phiri KS, Mwapasa V, ter Kuile FO, Maartens G, Barnes KI. Impact of Dolutegravir-Based Antiretroviral Therapy on Piperaquine Exposure following Dihydroartemisinin-Piperaquine Intermittent Preventive Treatment of Malaria in Pregnant Women Living with HIV. Antimicrob Agents Chemother 2022; 66:e0058422. [PMID: 36374096 PMCID: PMC9764988 DOI: 10.1128/aac.00584-22] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Dihydroartemisinin-piperaquine, an artemisinin-based combination therapy, has been identified as a promising agent for intermittent preventive treatment of malaria in pregnancy. However, in pregnant women living with HIV (PLWH), efavirenz-based antiretroviral therapy (ART) significantly reduces the plasma exposure of piperaquine. In an open-label, nonrandomized, fixed-sequence, pharmacokinetic study, we compared piperaquine plasma concentrations in 13 pregnant women during a 3-day treatment course of dihydroartemisinin-piperaquine when coadministered with efavirenz-based versus dolutegravir-based ART in the second or third trimester of pregnancy. Piperaquine concentrations were measured over a 28-day period, while on efavirenz-based ART and after switching to dolutegravir-based ART. Noncompartmental analysis was performed, and geometric mean ratios (GMRs) and 90% confidence intervals (CIs) were generated to compare piperaquine pharmacokinetic parameters between these two treatment periods. Compared with efavirenz-based ART, coadministration of dihydroartemisinin-piperaquine and dolutegravir-based ART resulted in a 57% higher overall piperaquine exposure (area under the concentration-time curve from 0 to 672 h [AUC0-672 h]) (GMR, 1.57; 90% CI, 1.28 to 1.93). Piperaquine's day 7 concentrations were also 63% higher (GMR, 1.63; 90% CI, 1.29 to 2.11), while day 28 concentrations were nearly three times higher (GMR, 2.96; 90% CI, 2.25 to 4.07). However, the maximum piperaquine concentration (Cmax) remained similar (GMR, 1.09; 90% CI, 0.79 to 1.49). Dihydroartemisinin-piperaquine was well tolerated, with no medication-related serious adverse events observed in this small study. Compared with efavirenz-based ART, a known inducer of piperaquine metabolism, dolutegravir-based ART resulted in increased overall piperaquine exposure with pharmacokinetic parameter values that were similar to those published previously for pregnant and nonpregnant women. Our findings suggest that the efficacy of dihydroartemisinin-piperaquine will be retained in pregnant women on dolutegravir. (The study was registered on PACTR.samrc.ac.za [PACTR201910580840196].).
Collapse
Affiliation(s)
- Clifford G. Banda
- Malawi-Liverpool-Wellcome Research Programme, Blantyre, Malawi
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Towngrid.7836.a, Cape Town, South Africa
- Kamuzu University of Health Sciences (formerly College of Medicine and Kamuzu College of Nursing, University of Malawi), Blantyre, Malawi
| | - Dumisile Nkosi
- Malawi-Liverpool-Wellcome Research Programme, Blantyre, Malawi
| | - Elizabeth Allen
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Towngrid.7836.a, Cape Town, South Africa
- WorldWide Antimalarial Resistance Network (WWARN), Pharmacology Scientific Group, University of Cape Towngrid.7836.a, Cape Town, South Africa
| | - Lesley Workman
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Towngrid.7836.a, Cape Town, South Africa
- WorldWide Antimalarial Resistance Network (WWARN), Pharmacology Scientific Group, University of Cape Towngrid.7836.a, Cape Town, South Africa
| | - Mwayiwawo Madanitsa
- Training and Research Unit of Excellence, Blantyre, Malawi
- Department of Clinical Sciences, Malawi University of Science and Technology, Limbe, Malawi
| | - Marumbo Chirwa
- Malawi-Liverpool-Wellcome Research Programme, Blantyre, Malawi
| | | | - Sharon Muyaya
- Training and Research Unit of Excellence, Blantyre, Malawi
| | - Steven Munharo
- Training and Research Unit of Excellence, Blantyre, Malawi
| | - Joel Tarning
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Kamija S. Phiri
- Kamuzu University of Health Sciences (formerly College of Medicine and Kamuzu College of Nursing, University of Malawi), Blantyre, Malawi
- Training and Research Unit of Excellence, Blantyre, Malawi
| | - Victor Mwapasa
- Kamuzu University of Health Sciences (formerly College of Medicine and Kamuzu College of Nursing, University of Malawi), Blantyre, Malawi
- Training and Research Unit of Excellence, Blantyre, Malawi
| | - Feiko O. ter Kuile
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Gary Maartens
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Towngrid.7836.a, Cape Town, South Africa
| | - Karen I. Barnes
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Towngrid.7836.a, Cape Town, South Africa
- WorldWide Antimalarial Resistance Network (WWARN), Pharmacology Scientific Group, University of Cape Towngrid.7836.a, Cape Town, South Africa
| |
Collapse
|
4
|
Mirzohreh ST, Safarpour H, Pagheh AS, Bangoura B, Barac A, Ahmadpour E. Malaria prevalence in HIV-positive children, pregnant women, and adults: a systematic review and meta-analysis. PARASITES & VECTORS 2022; 15:324. [PMID: 36104731 PMCID: PMC9472338 DOI: 10.1186/s13071-022-05432-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 08/15/2022] [Indexed: 11/10/2022]
Abstract
Abstract
Background
Malaria in human immunodeficiency virus (HIV)-positive patients is an ever-increasing global burden for human health. The present meta-analysis summarizes published literature on the prevalence of malaria infection in HIV-positive children, pregnant women and adults.
Methods
This study followed the PRISMA guideline. The PubMed, Science Direct, Google Scholar, Scopus and Cochrane databases were searched for relevant entries published between 1 January 1983 and 1 March 2020. All peer-reviewed original papers evaluating the prevalence of malaria among HIV-positive patients were included. Incoherence and heterogeneity between studies were quantified by the I2 index and Cochran’s Q test. Publication and population biases were assessed with funnel plots, and Egger’s regression asymmetry test.
Results
A total of 106 studies were included in this systematic review. The average prevalence of malaria among HIV-positive children, HIV-positive pregnant women and HIV-positive adults was 39.4% (95% confidence interval [CI]: 26.6–52.9), 32.3% (95% CI = 26.3–38.6) and 27.3% (95% CI = 20.1–35.1), respectively. In adult patients with HIV, CD4+ (cluster of differentiation 4) < 200 cells/µl and age < 40 years were associated with a significant increase in the odds of malaria infection (odds ratio [OR] = 1.5, 95% CI = 1.2–1.7 and OR = 1.1, 95% CI = 1–1.3, respectively). Antiretroviral therapy (ART) and being male were associated with a significant decrease in the chance of malaria infection in HIV-positive adults (OR = 0.8, 95% CI = 0.7–0.9 and OR = 0.2, 95% CI = 0.2–0.3, respectively). In pregnant women with HIV, CD4+ count < 200 cells/µl was related to a higher risk for malaria infection (OR = 1.5, 95% CI = 1.1–1.9).
Conclusions
This systematic review demonstrates that malaria infection is concerningly common among HIV-positive children, pregnant women and adults. Among HIV-positive adults, ART medication and being male were associated with a substantial decrease in infection with malaria. For pregnant women, CD4+ count of < 200 cells/µl was a considerable risk factor for malaria infection.
Graphical Abstract
Collapse
|
5
|
Alamneh TT, Tilahun SF, Beyne MB, Fekadu SA, Assem AS, Kassa SF. Prevalence and Associated Factors of Anemia Among Newborns at Tibebe Ghion Specialized Hospital, Northwest Ethiopia. Int J Gen Med 2022; 15:6465-6474. [PMID: 35966508 PMCID: PMC9365054 DOI: 10.2147/ijgm.s365817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 08/02/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction Anemia is a common hematological problem in neonatal admissions. Poor detection rate and inappropriate treatment adversely affect the growing infant. Data on the magnitude and risk factors of anemia in sick newborns are lacking in Ethiopia, so knowing the prevalence and risk factors may reduce the long-term untreated complications of anemia. Objective The overall aim of this study was to assess the prevalence and associated factors of anemia among newborns admitted to Tibebe Ghion specialized hospital. Methods A hospital-based cross-sectional study was conducted among 272 newborns admitted to Tibebe Ghion Specialized Hospital from February 1 to May 30, 2021. A pretested structured questionnaire containing socio-demographic, clinical, and laboratory parameters was used for the data collection. Data were collected by trained nurses and residents after obtaining ethical clearance. The data were entered through Epi-data version 4.6 and analyzed using SPSS version 23.0 computer software. Descriptive statistics were performed using frequency, mean and standard deviation. Bivariable and multivariable binary logistic regressions were done to identify risk factors of anemia. Adjusted odds ratio with 95% confidence interval at a p-value <0.05 was declared as a statistically significant variable in the multivariable logistic regression. Results About two-thirds 177 (65.1%) of the newborn babies were male and 152 (55.9%) of the newborn had a birth weight of ≥2500 grams. The most commonly diagnosed medical conditions were sepsis 218 (80.1%) and prematurity of birth 78 (28.7%). The prevalence of anemia among newborns in this study was 63 (23.2%) [19.1–28.7%]. Gestational age of 33–36 weeks (AOR=0.36: 95% CI=0.17–0.96) and maternal anemia (AOR=3.81: 95% CI=1.29–11.23) were significantly associated with newborn anemia. Conclusion The prevalence of anemia among newborns in Tibebe Ghion specialized hospital was high. Gestational age and maternal anemia were significantly associated with newborn anemia. So, it is better to properly educate and advise women about newborn anemia during antenatal care follow-up.
Collapse
Affiliation(s)
- Tazebew Tilahun Alamneh
- Department of Pediatrics and Child Health, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Shitahun Fente Tilahun
- Department of Pediatrics and Child Health, School of Medicine, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Melkamu Bedimo Beyne
- Department of Biostatistics and Epidemiology, Bahir Dar University, Bahir Dar, Ethiopia
| | - Sofonias Addis Fekadu
- Department of Optometry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Abel Sinshaw Assem
- Department of Optometry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Selam Fisiha Kassa
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
6
|
Tilahun D, Yimer MA, Zamanuel TG. High Magnitude of Neonatal Anemia Among Sick Newborns Admitted to University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. J Blood Med 2022; 13:293-302. [PMID: 35698546 PMCID: PMC9188329 DOI: 10.2147/jbm.s361675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 05/23/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction Anemia is a global health problem that affects all ages, particularly children under five years. If not treated early, childhood anemia results in impaired growth, delayed cognitive development, and organ dysfunction. There is a scarcity of studies on the prevalence of anemia among hospitalized sick neonates, especially in developing countries. Objective This study aimed to determine the magnitude of anemia and associated factors among hospitalized sick newborns at the University of Gondar Comprehensive Specialized Hospital (UOGCSH). Methods An institutional-based cross-sectional study was conducted among admitted newborns from June 1 to September 30, 2020. All newborns whose gestational age (GA) ≥28 weeks and postnatal age ≤28 days, admitted to UOGCSH during the study period were included in the study. Data were collected by pediatric residents and a systematic random sampling technique was used to select the study participants. Statistical analysis was performed using SPSS version 20. Binary logistic regression was used to identify associated factors with neonatal anemia. P-value <0.05 was considered statistically significant. Results During the study period, 272 newborns were enrolled. The mean hemoglobin value was 15.74 ± 4.27 gm/dL. The prevalence of neonatal anemia in the study population was 30.1% (95% CI: 24.6–35.7). Neonatal age >7 days (AOR = 4.41, 95% CI: 1.86–10.5), maternal anemia (AOR = 9.93, 95% CI: 4.36–21.6), antepartum hemorrhage (AOR = 4.05, 95% CI: 1.54–10. 7), being multiple births (AOR = 4.70, 95% CI: 1.73–12.8), subgaleal hemorrhage (AOR = 7.56, 95%: 1.87–30.6), and hyperbilirubinemia (AOR = 3.84, 95% CI: 1.58–9.31) were associated with neonatal anemia. Conclusion and Recommendation The prevalence of anemia among hospitalized newborns was high. The current study recommends that healthcare providers should screen anemia among sick newborns who had risk factors. Prevention of maternal anemia and early treatment of obstetric complications will reduce the burden of anemia in sick neonates.
Collapse
Affiliation(s)
- Degalem Tilahun
- Department of Pediatrics and Child Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mulugeta Ayalew Yimer
- Department of Pediatrics and Child Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Teshome Geletaw Zamanuel
- Department of Pediatrics and Child Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Correspondence: Teshome Geletaw Zamanuel, Department of Pediatrics and Child Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia, Tel +251 913227167, Email
| |
Collapse
|
7
|
Banda CG, Nkosi D, Allen E, Workman L, Madanitsa M, Chirwa M, Kapulula M, Muyaya S, Munharo S, Wiesner L, Phiri KS, Mwapasa V, Ter Kuile FO, Maartens G, Barnes KI. Effect of dihydroartemisinin/piperaquine for malaria intermittent preventive treatment on dolutegravir exposure in pregnant women living with HIV. J Antimicrob Chemother 2022; 77:1733-1737. [PMID: 35288747 PMCID: PMC9155593 DOI: 10.1093/jac/dkac081] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 02/18/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND In sub-Saharan Africa, the burdens of malaria and HIV infections overlap. In settings with moderate-to-high malaria transmission intensity, pregnant women living with HIV (PLWH) require both ART and malaria intermittent preventive treatment (IPTp). Dihydroartemisinin/piperaquine has been identified as a promising alternative to sulfadoxine/pyrimethamine for IPTp. However, another antimalarial drug, artesunate/amodiaquine, similar to dihydroartemisinin/piperaquine, was previously shown to reduce dolutegravir exposure in non-pregnant adults. OBJECTIVES To investigate the effect of dihydroartemisinin/piperaquine on dolutegravir plasma exposure in pregnant women on dolutegravir-based ART. METHODS We conducted an open-label, non-randomized, fixed-sequence, pharmacokinetic study in PLWH in Malawi. Dolutegravir concentrations were measured over a 24 h period, before and after the recommended 3 day treatment dose of dihydroartemisinin/piperaquine in 12 pregnant women in their second or third trimester. Non-compartmental analysis was performed, and geometric mean ratios (GMRs) and 90% CIs were generated to compare dolutegravir pharmacokinetic parameters between the two treatment periods. RESULTS Co-administration of dihydroartemisinin/piperaquine and dolutegravir increased dolutegravir's overall exposure (AUC0-24) and Cmax by 30% (GMR 1.30; 90% CI 1.11-1.52) and 31% (GMR 1.31; 90% CI 1.13-1.51), respectively. The dolutegravir trough (C24) concentration increased by 42% (GMR 1.42; 90% CI 1.09-1.85). The combined treatments were well tolerated with no serious adverse events observed. CONCLUSIONS Dihydroartemisinin/piperaquine may be administered with dolutegravir-based ART in pregnant women as the modest increase in dolutegravir exposure, similar to pharmacokinetic parameter values published previously, ensures its efficacy without any clinically significant adverse events observed in this small study.
Collapse
Affiliation(s)
- Clifford G. Banda
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa
- Kamuzu University of Health Sciences, Blantyre, Malawi (formerly College of Medicine and Kamuzu College of Nursing, University of Malawi)
| | - Dumisile Nkosi
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi
| | - Elizabeth Allen
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa
- WorldWide Antimalarial Resistance Network (WWARN), Pharmacology Scientific Group, University of Cape Town, Cape Town, South Africa
| | - Lesley Workman
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa
- WorldWide Antimalarial Resistance Network (WWARN), Pharmacology Scientific Group, University of Cape Town, Cape Town, South Africa
| | - Mwayiwawo Madanitsa
- Training and Research Unit of Excellence, Blantyre, Malawi
- Department of Clinical Sciences, Malawi University of Science and Technology, Limbe, Malawi
| | - Marumbo Chirwa
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi
| | | | - Sharon Muyaya
- Training and Research Unit of Excellence, Blantyre, Malawi
| | - Steven Munharo
- Training and Research Unit of Excellence, Blantyre, Malawi
| | - Lubbe Wiesner
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Kamija S. Phiri
- Kamuzu University of Health Sciences, Blantyre, Malawi (formerly College of Medicine and Kamuzu College of Nursing, University of Malawi)
- Training and Research Unit of Excellence, Blantyre, Malawi
| | - Victor Mwapasa
- Kamuzu University of Health Sciences, Blantyre, Malawi (formerly College of Medicine and Kamuzu College of Nursing, University of Malawi)
| | - Feiko O. Ter Kuile
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Gary Maartens
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Karen I. Barnes
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa
- WorldWide Antimalarial Resistance Network (WWARN), Pharmacology Scientific Group, University of Cape Town, Cape Town, South Africa
- Corresponding author. E-mail:
| |
Collapse
|
8
|
Nathem Rashed R. Effect biological life factors on pregnant woman. BIONATURA 2022. [DOI: 10.21931/rb/2022.07.02.47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Define anemia is the low concentration in the amount of hemoglobin according to age, sex and trimester pregnancy. The pregnant has three trimesters and has an exceptional hemoglobin range in every trimester. The pregnant has 124-135 g/dl in the 1st trimester, 110-117 g/dl in the 2nd trimester and 106-109 g/dl in the 3rd trimester. Many pregnant females had been found with anemia because of a low level of Iron. This leads to megaloblastic anemia because of iron deficiency anemia and B12 Vitamin, diet, gastrectomy, malabsorption, blood loss and physiological demand (pregnancy infancy and adolescence). The blood consists of Hemoglobin (Heam + globin) Heam and Iron protoporphyrin ring. Globin is the type of protein with a specific length of amino acid and a specific type of A, maybe 2 Alpha 2 Beta called A1 or 2 Alpha and 2 Bata called A2 or 2Alpha and Gamma called F Fetal. The production of hemoglobin depends on the previously mentioned factors. In this study, we focused on some factors associated with the amount of blood and how these factors affected anemia, which is the most important in Iron treatments, with considering other factors such as food, diversity, Economic situation, social status, number of the fetus, and number of pregnancies. Statistical analysis was used to detect the effect factors of anemia in pregnant. This study refers to 23.2% of anemia because of Iron deficiency during pregnancy. So, treatment of Iron deficiency reduces anemia during pregnancy time.
Keywords. Anemia; Hemoglobin; Pregnant Woman
Collapse
Affiliation(s)
- Rawya Nathem Rashed
- Umm Al-rabeein High School for Outstanding Students _Directorate General of Education Nineveh. Mosul - Iraq
| |
Collapse
|
9
|
Prevalence of Malaria and Associated Factors among Delivering Mothers in Northwest Ethiopia. BIOMED RESEARCH INTERNATIONAL 2021; 2021:2754407. [PMID: 34917681 PMCID: PMC8670928 DOI: 10.1155/2021/2754407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 11/23/2021] [Indexed: 12/04/2022]
Abstract
Background Malaria is one of the leading causes of morbidity and mortality especially in pregnant women and under-five-year-old children. However, data on the prevalence among delivering mothers, potential fetal transmission, and associated birth outcomes is lacking in Ethiopia. Objective To assess the prevalence of Plasmodium infection from peripheral, placental, and cord blood samples among delivering mothers in Kuch health center, Northwest Ethiopia. Methods An institution-based cross-sectional study was conducted among 218 delivering mothers from February to May 2021 in Kuch health center. Data on sociodemographic characteristics and clinical and obstetric history of mothers were collected using a structured questionnaire. Giemsa stained blood films from maternal capillary and placental and umbilical cord blood were examined for plasmodium infection. Data were analyzed using Statistical Package for the Social Sciences version 23 software package. Results The prevalence of maternal, placental, and umbilical cord malaria was 6.4% (14/218), 2.3% (5/218), and 0.5% (1/218), respectively. Plasmodium falciparum and Plasmodium vivax accounted 3.7% (8/218) and 2.8% (6/218), respectively, in maternal peripheral blood but only Plasmodium falciparum was detected in placental and umbilical cord blood samples. Maternal malaria had significant association with primigravida (χ2 = 12.611, p = 0.002) and low birth weight (χ2 = 8.381, p = 0.004). Placental malaria was also significantly associated with low birth weight (χ2 = 32.255, p ≤ 0.001). Conclusion The prevalence of malaria among delivering mothers was considerable. Maternal peripheral malaria had a significant association with gravidity and birth weight. Placental and umbilical cord malaria also had a significant association with birth weight. Pregnant mothers should be examined for malaria and receive appropriate treatment to prevent adverse birth outcomes.
Collapse
|
10
|
Dereje I, Etefa T, Gebremariam T, Getaye A, Tunta A, Gerbi A. Prevalence of Anemia and Associated Factors Among Term Newborns in Nekemte Specialized Hospital, Western Ethiopia. J Multidiscip Healthc 2021; 14:2607-2615. [PMID: 34556995 PMCID: PMC8455289 DOI: 10.2147/jmdh.s326962] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 08/27/2021] [Indexed: 11/29/2022] Open
Abstract
Background Anemia is a global public health problem that affects approximately one-third of the global population. Infants and children are the ones to develop both short-term and long-term devastating complications from anemia. Although anemia is a very big public health concern, newborns, especially in developing countries, are usually overlooked and undiagnosed. Purpose The aim of this study was to assess the prevalence of anemia and associated factors among term newborns in Nekemte Specialized Hospital, Western Ethiopia. Methods A facility-based cross-sectional study involving 278 newborns was conducted from October to November, 2020 with an interview-based questionnaire that included maternal socio-demographic and obstetrics characteristics, newborn’s weight and sex. The data were analyzed with SPSS version 20. The prevalence of newborn anemia was shown in percentage and as a pie-chart. Bivariate analysis and binary logistic regression were used to identify the predictors of anemia in the term newborn. Results The overall prevalence of newborn anemia in the hospital was 29.1%. Maternal anemia (AOR: 3.95, 95% C.I.: 1.97–7.92), delivery by cesarean section (AOR: 4.17, 95% C.I.: 1.89–9.20), vaginal bleeding during pregnancy (AOR: 5.43, 95% C.I.: 1.60–18.39), and maternal failure to take iron-folate supplements during pregnancy (AOR: 2.17, 95% C.I.:1.07–4.41) were factors associated with newborn anemia. Conclusion Anemia among newborns in the hospital was a moderate public health problem. Policy makers should consider maternal health education and appropriate health interventions to reduce the problem. In addition, further longitudinal studies are needed to identify specific causes of newborn anemia in order to prevent the possible complications.
Collapse
Affiliation(s)
- Ifa Dereje
- Department of Medicine, College of Health Sciences, Salale University, Fiche, Oromia, Ethiopia
| | - Tesema Etefa
- Human Anatomy Unit, Department of Biomedical Sciences, Faculty of Medical Science, Institute of Health, Jimma University, Jimma, Oromia, Ethiopia
| | - Teka Gebremariam
- Human Anatomy Unit, Department of Biomedical Sciences, Faculty of Medical Science, Institute of Health, Jimma University, Jimma, Oromia, Ethiopia
| | - Asfaw Getaye
- Department of Nursing, College of Health Science, Salale University, Fitche, Oromia, Ethiopia
| | - Abayneh Tunta
- Department of Biomedical Sciences, Faculty of Health Sciences, Woldia University, Woldia, Amhara, Ethiopia
| | - Asfaw Gerbi
- Human Anatomy Unit, Department of Biomedical Sciences, Faculty of Medical Science, Institute of Health, Jimma University, Jimma, Oromia, Ethiopia
| |
Collapse
|
11
|
Dosoo DK, Malm K, Oppong FB, Gyasi R, Oduro A, Williams J, Atibilla D, Peprah NY, Twumasi M, Owusu-Agyei S, Greenwood B, Chandramohan D, Asante KP. Effectiveness of intermittent preventive treatment in pregnancy with sulphadoxine-pyrimethamine (IPTp-SP) in Ghana. BMJ Glob Health 2021; 6:bmjgh-2021-005877. [PMID: 34417272 PMCID: PMC8381314 DOI: 10.1136/bmjgh-2021-005877] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 08/08/2021] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Ghana adopted the revised WHO recommendation on intermittent preventive treatment in pregnancy using sulfadoxine-pyrimethamine (IPTp-SP) in 2012. This study has assessed the effectiveness and safety of this policy in Ghana. METHODS A total of 1926 pregnant women enrolled at antenatal care (ANC) clinics were assessed for birth outcomes at delivery, and placental histology results for malaria infection were obtained from 1642 participants. Association of reduced placental or peripheral malaria, anaemia and low birth weight (LBW) in women who received ≥4 IPTp-SP doses compared with 3 or ≤2 doses was determined by logistic regression analysis. RESULTS Among the 1926 participants, 5.3% (103), 19.2% (369), 33.2% (640) and 42.3% (817) of women had received ≤1, 2, 3 or ≥4 doses, respectively. There was no difference in risk of active placental malaria (PM) infection in women who received 3 doses compared with ≥4 doses (adjusted OR (aOR) 1.00, 95% CI 0.47 to 2.14). The risk of overall PM infection was 1.63 (95% CI 1.07 to 2.48) in 2 dose group and 1.06 (95% CI 0.72 to 1.57) in 3 dose group compared with ≥4 dose group. The risk of LBW was 1.55 (95% CI 0.97 to 2.47) and 1.06 (95% CI 0.68 to 1.65) for 2 and 3 dose groups, respectively, compared with the ≥4 dose group. Jaundice in babies was present in 0.16%, and 0% for women who received ≥4 doses of SP. CONCLUSION There was no difference in the risk of PM, LBW or maternal anaemia among women receiving 3 doses compared with ≥4 doses. Receiving ≥3 IPTp-SP doses during pregnancy was associated with a lower risk of overall PM infection compared with 2 doses. As there are no safety concerns, monthly administration of IPTp-SP offers a more practical opportunity for pregnant women to receive ≥3 doses during pregnancy.
Collapse
Affiliation(s)
- David Kwame Dosoo
- Department of Disease Control, London School of Hygiene and Tropical Medicine, Faculty of Infectious and Tropical Diseases, London, UK .,Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo, Ghana
| | - Kezia Malm
- National Malaria Control Programme, Ghana Health Service, Accra, Ghana
| | - Felix Boakye Oppong
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo, Ghana
| | - Richard Gyasi
- Department of Pathology, University of Ghana College of Health Sciences, Accra, Ghana
| | - Abraham Oduro
- Navrongo Health Research Centre, Research and Development Division, Ghana Health Service, Accra, Ghana.,Ghana Health Service Research and Development Division, Accra, Ghana
| | - John Williams
- Dodowa Health Research Centre, Research and Development Division, Ghana Health Service, Dodowa, Ghana
| | - Dorcas Atibilla
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo, Ghana
| | - Nana Yaw Peprah
- National Malaria Control Programme, Ghana Health Service, Accra, Ghana
| | - Mieks Twumasi
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo, Ghana
| | - Seth Owusu-Agyei
- Department of Disease Control, London School of Hygiene and Tropical Medicine, Faculty of Infectious and Tropical Diseases, London, UK.,Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo, Ghana.,Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana
| | - Brian Greenwood
- Department of Disease Control, London School of Hygiene and Tropical Medicine, Faculty of Infectious and Tropical Diseases, London, UK
| | - Daniel Chandramohan
- Department of Disease Control, London School of Hygiene and Tropical Medicine, Faculty of Infectious and Tropical Diseases, London, UK
| | - Kwaku Poku Asante
- Department of Disease Control, London School of Hygiene and Tropical Medicine, Faculty of Infectious and Tropical Diseases, London, UK.,Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo, Ghana
| |
Collapse
|
12
|
Kabyemela ER, Fried M, Kurtis JD, Moses G, Gorres JP, Muehlenbachs A, Duffy PE. Fetal Cytokine Balance, Erythropoietin and Thalassemia but Not Placental Malaria Contribute to Fetal Anemia Risk in Tanzania. Front Immunol 2021; 12:624136. [PMID: 33995348 PMCID: PMC8120033 DOI: 10.3389/fimmu.2021.624136] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 03/19/2021] [Indexed: 12/21/2022] Open
Abstract
Fetal anemia is common in malaria-endemic areas and a risk factor for anemia as well as mortality during infancy. Placental malaria (PM) and red cell abnormalities have been proposed as possible etiologies, but the relationship between PM and fetal anemia has varied in earlier studies, and the role of red cell abnormalities has not been studied in malaria-endemic areas. In a Tanzanian birth cohort study designed to elucidate the pathogenesis of severe malaria in young infants, we performed a cross-sectional analysis of risk factors for fetal anemia. We determined PM status, newborn red cell abnormalities, and maternal and cord blood levels of iron regulatory proteins, erythropoietin (EPO), cytokines and cytokine receptors. We examined the relationship between these factors and fetal anemia. Fetal anemia was present in 46.2% of the neonates but was not related to PM. Maternal iron deficiency was common (81.6%), most frequent in multigravidae, and interacted with parity to modify risk of fetal anemia, but it was not directly related to risk. Among offspring of iron-deficient women, the odds of fetal anemia increased with fetal α+-thalassemia, as well as these patterns of cord blood cytokines: increased cord IL-6, decreased TNF-RI, and decreased sTfR. The EPO response to fetal anemia was low or absent and EPO levels were significantly decreased in newborns with the most severe anemia. This study from an area of high malaria transmission provides evidence that 1) fetal α+-thalassemia and cytokine balance, but not PM at delivery, are related to fetal anemia; 2) maternal iron deficiency increases the risk that other factors may cause fetal anemia; and 3) fetal anemia has a multifactorial etiology that may require a variety of interventions, although measures that reduce maternal iron deficiency may be generally beneficial.
Collapse
Affiliation(s)
- Edward R Kabyemela
- Mother Offspring Malaria Studies (MOMS) Project, Seattle Biomedical Research Institute, Seattle, WA, United States.,School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Michal Fried
- Mother Offspring Malaria Studies (MOMS) Project, Seattle Biomedical Research Institute, Seattle, WA, United States.,Laboratory of Malaria Immunology and Vaccinology, National Institutes of Allergy and Infectious Diseases, National Institutes of Health (NIH), Bethesda, MD, United States
| | - Jonathan D Kurtis
- Department of Pathology and Laboratory Medicine, Center for International Health Research, Rhode Island Hospital, Brown University, Providence, RI, United States
| | - Gwamaka Moses
- Mother Offspring Malaria Studies (MOMS) Project, Seattle Biomedical Research Institute, Seattle, WA, United States.,Mbeya College of Health and Allied Sciences, University of Dar es Salaam, Mbeya, Tanzania
| | - J Patrick Gorres
- Laboratory of Malaria Immunology and Vaccinology, National Institutes of Allergy and Infectious Diseases, National Institutes of Health (NIH), Bethesda, MD, United States
| | - Atis Muehlenbachs
- Mother Offspring Malaria Studies (MOMS) Project, Seattle Biomedical Research Institute, Seattle, WA, United States
| | - Patrick E Duffy
- Mother Offspring Malaria Studies (MOMS) Project, Seattle Biomedical Research Institute, Seattle, WA, United States.,Laboratory of Malaria Immunology and Vaccinology, National Institutes of Allergy and Infectious Diseases, National Institutes of Health (NIH), Bethesda, MD, United States
| |
Collapse
|
13
|
Mlugu EM, Minzi O, Kamuhabwa AAR, Aklillu E. Effectiveness of Intermittent Preventive Treatment With Dihydroartemisinin-Piperaqunine Against Malaria in Pregnancy in Tanzania: A Randomized Controlled Trial. Clin Pharmacol Ther 2021; 110:1478-1489. [PMID: 33891721 DOI: 10.1002/cpt.2273] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 03/30/2021] [Indexed: 11/10/2022]
Abstract
Intermittent preventive treatment in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP) to prevent malaria and adverse birth outcomes is threatened by Plasmodium falciparum resistance to sulfadoxine-pyrimethamine. We investigated the effectiveness of intermittent preventive treatment in pregnancy with monthly dihydroartemisinin-piperaquine (IPTp-DHP) as an alternative option to IPTp-SP. A total of 956 malaria-free (malaria rapid diagnostic test (MRDT) negative) pregnant women from moderate malaria transmission areas in Tanzania were enrolled and randomized to receive monthly IPTp-DHP (n = 478) or IPTp-SP (n = 478) and followed for maternal and birth outcomes. The primary outcome was the prevalence of histopathologically confirmed placental malaria (active or past infection). Secondary outcomes were overall malaria at delivery, symptomatic-malaria, parasitemia during pregnancy, and adverse birth outcomes as a composite of spontaneous-abortion, premature birth, stillbirth, and low birth weight (LBW) fetal anemia. Outcome differences between treatment groups were expressed as the protective efficacy (PE), defined as 1-prevalence ratios or 1-incidence rate ratio. The prevalence of histopathologically confirmed placental malaria was significantly lower in IPTp-DHP (2.5%, 12/478) than IPTp-SP (8.2%, 39/478); PE = 69% (95% confidence interval (CI): 42-84, P < 0.001). The prevalence of maternal malaria at delivery was significantly lower in IPTp-DHP (8.2%) than IPTp-SP (18.2%, P < 0.001). The incidence per person-years at risk for symptomatic-malaria (0.02 vs. 0.12, P = 0.002) and parasitemia during pregnancy (0.28 vs. 0.67, P < 0.001) were significantly lower in the IPTp-DHP group than in the IPTp-SP group. The prevalence of any adverse birth outcomes (composite) was not significantly (P = 0.06) different between IPTp-DHP (17.9%) and IPTp-SP (23.8%). However, the prevalence of LBW (4.6% vs. 9.6%, P = 0.003) was significantly lower in IPTp-DHP compared with IPTp-SP. We report superior protective efficacy of monthly IPTp-DHP against malaria in pregnancy and LBW than IPTp-SP.
Collapse
Affiliation(s)
- Eulambius M Mlugu
- Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden.,Department of Pharmaceutics and Pharmacy Practice, School of Pharmacy, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Omary Minzi
- Department of Clinical Pharmacy and Pharmacology, School of Pharmacy, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Appolinary A R Kamuhabwa
- Department of Clinical Pharmacy and Pharmacology, School of Pharmacy, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Eleni Aklillu
- Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden
| |
Collapse
|
14
|
Saldanha P. Hydropic placenta in a case of malaria. MGM JOURNAL OF MEDICAL SCIENCES 2021. [DOI: 10.4103/mgmj.mgmj_93_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
15
|
Methazia J, Ngamasana EL, Utembe W, Ogunrombi M, Nyasulu P. An investigation of maternal anaemia among HIV infected pregnant women on antiretroviral treatment in Johannesburg, South Africa. Pan Afr Med J 2020; 37:93. [PMID: 33425126 PMCID: PMC7757230 DOI: 10.11604/pamj.2020.37.93.22244] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 03/18/2020] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION maternal anaemia is a major public health problem in developing countries. Data suggests that anaemia contributes to the progression of Human Immunodeficiency Virus (HIV)-infection. The aim of this study was to investigate if pregnancy was an aggravating factor for anaemia among HIV-positive women on anti-retroviral treatment (ART). METHODS we analyzed data of all HIV-positive women aged 18-49 years receiving ART at Themba Lethu Clinic, Helen Joseph Hospital, Johannesburg, South Africa, from 1st April 2004- 30t hApril 2011. HIV-positive pregnant women were matched with non-pregnant women using the year of initiation of treatment. The outcome of interest ´anaemia´ was defined as "no anaemia", "anaemia" and "moderate/severe anaemia". We fitted an ordered logistic regression model to predict the likelihood of having severe/moderate anaemia versus no anaemia. We included pregnancy status as a predictor of the outcome and controlled the effect of other covariates in the analysis. RESULTS the study included 236 HIV positive patients, of which half (n=118, 50%) were pregnant. At baseline, about (n=143, 60%) of patients were anaemic. The proportion of pregnant women classified as anaemic (anaemia, moderate/severe) differed significantly (p=0.02) from that of non-pregnant women. The following characteristics were significantly associated with anaemia at baseline: Body mass index (BMI) category (p=0.01); World Health Organization (WHO) stage (p=0.001) and CD4 count (p=0.001). Seven months after initiation of treatment, the proportion of HIV positive women with anaemia decreased significantly. CONCLUSION anaemia is a significant risk factor for untoward health outcomes, especially among HIV-positive pregnant women. Early ART access might result in a significant decrease in anaemia in pregnancy.
Collapse
Affiliation(s)
- Jewelle Methazia
- Ibis Reproductive Health, Parktown, Johannesburg, South Africa
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Emery Ladi Ngamasana
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Wells Utembe
- National Institute for Occupational Health, National Health Laboratory Services, Johannesburg, South Africa
| | - Modupe Ogunrombi
- Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - Peter Nyasulu
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| |
Collapse
|
16
|
Ssentongo P, Ba DM, Ssentongo AE, Ericson JE, Wang M, Liao D, Chinchilli VM. Associations of malaria, HIV, and coinfection, with anemia in pregnancy in sub-Saharan Africa: a population-based cross-sectional study. BMC Pregnancy Childbirth 2020; 20:379. [PMID: 32600355 PMCID: PMC7324981 DOI: 10.1186/s12884-020-03064-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 06/17/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Malaria and HIV are common infections in Africa and cause substantial morbidity and mortality in pregnant women. We aimed to assess the association of malaria with anemia in pregnant women and to explore the joint effects of malaria and HIV infection on anemia in pregnant women. METHODS We used nationally representative, cross-sectional demographic and health surveys (DHS) that were conducted between 2012 and 2017 across 7 countries of sub-Saharan Africa (Burundi, the Democratic Republic of the Congo, Gambia, Ghana, Mali, Senegal and Togo). The outcome variables were anemia (defined as a hemoglobin concentration < 110 g/L), and hemoglobin concentration on a continuous scale, in pregnant women at the time of the interview. We used generalized linear mixed-effects models to account for the nested structure of the data. We adjusted models for individual covariates, with random effects of the primary sampling unit nested within a country. RESULTS A total of 947 pregnant women, ages, 15-49 y, were analyzed. Prevalence of malaria only, HIV only, and malaria- HIV coinfection in pregnant women was 31% (95% CI: 28.5 to 34.5%, n = 293), 1.3% (95% CI: 0.77 to 2.4%, n = 13) and 0.52% (95% CI: 0.02 to 1.3%, n = 5) respectively. Overall prevalence of anemia was 48.3% (95% CI: 45.1 to 51.5%). The anemia prevalence in pregnant women with malaria infection only was 56.0% (95% CI: 50.1 to 61.7%); HIV infection only, 62.5% (95% CI: 25.9 to 89.8%); malaria- HIV coinfection, 60.0 (95% CI: 17.0-92.7%) and without either infection, 44.6% (95% CI: 40.7 to 48.6%). In the fully adjusted models, malaria infection was associated with 27% higher prevalence of anemia (95% CI of prevalence ratio: 1.12 to 1.45; p = 0.004), and 3.4 g/L lower hemoglobin concentration (95% CI: - 5.01 to - 1.79; p = 0.03) compared to uninfected pregnant women. The prevalence of HIV infection and malaria-HIV coinfection was too low to allow meaningful analysis of their association with anemia or hemoglobin concentration. CONCLUSION Malaria was associated with an increased prevalence of anemia during pregnancy.
Collapse
Affiliation(s)
- Paddy Ssentongo
- Center for Neural Engineering, Department of Engineering, Science and Mechanics, Penn State University, University Park, PA USA
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA USA
| | - Djibril M. Ba
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA USA
- Center for Applied Studies in Health Economics, Penn State College of Medicine, Hershey, PA USA
| | - Anna E. Ssentongo
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA USA
| | - Jessica E. Ericson
- Department of Pediatrics, Penn State College of Medicine, Hershey, PA USA
| | - Ming Wang
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA USA
| | - Duanping Liao
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA USA
| | - Vernon M. Chinchilli
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA USA
| |
Collapse
|
17
|
Mikomangwa WP, Minzi O, Mutagonda R, Baraka V, Mlugu EM, Aklillu E, Kamuhabwa AAR. Effect of sulfadoxine-pyrimethamine doses for prevention of malaria during pregnancy in hypoendemic area in Tanzania. Malar J 2020; 19:160. [PMID: 32306955 PMCID: PMC7168863 DOI: 10.1186/s12936-020-03234-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 04/11/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Malaria in pregnancy increases the risk of deleterious maternal and birth outcomes. The use of ≥ 3 doses of sulfadoxine-pyrimethamine (SP) for intermittent preventive treatment of malaria (IPTp-SP) is recommended for preventing the consequences of malaria during pregnancy. This study assessed the effect of IPTp-SP for prevention of malaria during pregnancy in low transmission settings. METHODS A cross-sectional study that involved consecutively selected 1161 pregnant women was conducted at Mwananyamala regional referral hospital in Dar es Salaam. Assessment of the uptake of IPTp-SP was done by extracting information from antenatal clinic cards. Maternal venous blood, cord blood, placental blood and placental biopsy were collected for assessment of anaemia and malaria. High performance liquid chromatography with ultraviolet detection (HPLC-UV) was used to detect and quantify sulfadoxine (SDX). Dried blood spots (DBS) of placental blood were collected for determination of sub-microscopic malaria using polymerase chain reaction (PCR). RESULTS In total, 397 (34.2%) pregnant women reported to have used sub-optimal doses (≤ 2) while 764 (65.8%) used optimal doses (≥ 3) of IPTp-SP at the time of delivery. The prevalence of placental malaria as determined by histology was 3.6%. Submicroscopic placental malaria was detected in 1.4% of the study participants. Women with peripheral malaria had six times risk of maternal anaemia than those who were malaria negative (aOR, 5.83; 95% CI 1.10-30.92; p = 0.04). The geometric mean plasma SDX concentration was 10.76 ± 2.51 μg/mL. Sub-optimal IPTp-SP dose was not associated with placental malaria, premature delivery and fetal anaemia. The use of ≤ 2 doses of IPTp-SP increased the risk of maternal anaemia by 1.36-fold compared to ≥ 3 doses (aOR, 1.36; 95% CI 1.04-1.79; p = 0.02). CONCLUSION The use of < 2 doses of IPTp-SP increased the risk of maternal anaemia. However, sub-optimal doses (≤ 2 doses) were not associated with increased the risk of malaria parasitaemia, fetal anaemia and preterm delivery among pregnant women in low malaria transmission setting. The use of optimal doses (≥ 3 doses) of IPTp-SP and complementary interventions should continue even in areas with low malaria transmission.
Collapse
Affiliation(s)
- Wigilya P Mikomangwa
- Clinical Pharmacy and Pharmacology Department, Muhimbili University of Health and Allied Sciences, Dar es Salaam, United Republic of Tanzania.
| | - Omary Minzi
- Clinical Pharmacy and Pharmacology Department, Muhimbili University of Health and Allied Sciences, Dar es Salaam, United Republic of Tanzania
| | - Ritah Mutagonda
- Clinical Pharmacy and Pharmacology Department, Muhimbili University of Health and Allied Sciences, Dar es Salaam, United Republic of Tanzania
| | - Vito Baraka
- National Institute for Medical Research, Tanga Centre, Tanga, United Republic of Tanzania
| | - Eulambius M Mlugu
- Pharmaceutics and Pharmacy Practice Department, Muhimbili University of Health and Allied Sciences, Dar es Salaam, United Republic of Tanzania
| | - Eleni Aklillu
- Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital-Huddinge C1:68, 141 86, Stockholm, Sweden
| | - Appolinary A R Kamuhabwa
- Clinical Pharmacy and Pharmacology Department, Muhimbili University of Health and Allied Sciences, Dar es Salaam, United Republic of Tanzania
| |
Collapse
|
18
|
Mlugu EM, Minzi O, Asghar M, Färnert A, Kamuhabwa AA, Aklillu E. Effectiveness of Sulfadoxine-Pyrimethamine for Intermittent Preventive Treatment of Malaria and Adverse Birth Outcomes in Pregnant Women. Pathogens 2020; 9:pathogens9030207. [PMID: 32168945 PMCID: PMC7157612 DOI: 10.3390/pathogens9030207] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 03/09/2020] [Accepted: 03/10/2020] [Indexed: 12/28/2022] Open
Abstract
Effectiveness of intermittent preventive treatment in pregnancy with sulfadoxine–pyrimethamine (IPTp-SP) for prevention of malaria and adverse birth outcomes can be compromised by parasites-resistance to sulfadoxine–pyrimethamine. This study prospectively evaluated the effectiveness of IPTp-SP in Southeast Tanzania. From January 2017 to May 2019, HIV-negative and malaria-negative (mRDT) pregnant women attending their first antenatal-care visit in the second or third trimester (n = 500) were enrolled to receive monthly IPTp-SP and followed the protocol till delivery. The primary outcome was the prevalence of histopathological placental malaria. Secondary outcomes were anemia, malaria parasites detected during pregnancy and at delivery, adverse birth outcomes (low-birth-weight [LBW], premature birth, fetal anemia, still birth, and spontaneous abortion). Rates of histopathological placental malaria, any parasitemia at delivery (placental, cord or maternal), and any adverse birth outcome were 9.4%, 20.9%, and 26.5%, respectively. Rates of symptomatic malaria and parasitemia during pregnancy were 2.8% and 16%, respectively. Histopathological placental malaria significantly increased the odds of any adverse birth outcomes, particularly LBW. IPTp-SP with more than or equal to three doses significantly improved birth weight and reduced the risk of LBW by 56% compared to <3 SP doses (p = 0.009). IPTp-SP with more than or equal to three doses is still effective in improving birth weight. However, the detection of histopathological placental-malaria in one-tenth and parasitemia in one-fifth of pregnant women reflects the need to optimize the prevention of malaria during pregnancy.
Collapse
Affiliation(s)
- Eulambius M. Mlugu
- Department of Pharmaceutics, School of Pharmacy, Muhimbili University of Health and Allied Sciences, Dar es Salaam 0702172, Tanzania;
- Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet at Karolinska University Hospital, 141 86 Stockholm, Sweden
| | - Omary Minzi
- Department of Clinical Pharmacy and Pharmacology, School of Pharmacy, Muhimbili University of Health and Allied Sciences, Dar es Salaam 0702172, Tanzania; (O.M.)
| | - Muhammad Asghar
- Division of Infectious Diseases, Department of Medicine Solna, Karolinska Institutet, 171 76 Stockholm, Sweden; (M.A.); (A.F.)
- Department of Infectious Diseases, Karolinska University Hospital, 171 76 Stockholm, Sweden
| | - Anna Färnert
- Division of Infectious Diseases, Department of Medicine Solna, Karolinska Institutet, 171 76 Stockholm, Sweden; (M.A.); (A.F.)
- Department of Infectious Diseases, Karolinska University Hospital, 171 76 Stockholm, Sweden
| | - Appolinary A.R. Kamuhabwa
- Department of Clinical Pharmacy and Pharmacology, School of Pharmacy, Muhimbili University of Health and Allied Sciences, Dar es Salaam 0702172, Tanzania; (O.M.)
| | - Eleni Aklillu
- Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet at Karolinska University Hospital, 141 86 Stockholm, Sweden
- Correspondence:
| |
Collapse
|
19
|
Tiruneh T, Shiferaw E, Enawgaw B. Prevalence and associated factors of anemia among full-term newborn babies at University of Gondar comprehensive specialized hospital, Northwest Ethiopia: a cross-sectional study. Ital J Pediatr 2020; 46:1. [PMID: 31900190 PMCID: PMC6942365 DOI: 10.1186/s13052-019-0764-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 12/19/2019] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Anemia in newborn babies causes asymptomatic to an acute life-threatening event. If untreated, it leads to a delay in brain maturation, tissue hypoxia, and stunted growth. In Sub-Saharan Africa, its burden ranges 23-66%. However, in Ethiopia, there is limited information regarding the prevalence and associated factors of newborn anemia. Thus, this study was aimed to assess the prevalence and associated factors of anemia among full-term newborn babies. METHOD Cross-sectional study was conducted from February 1 to April 30, 2019, among 192 full-term newborn babies. A systematic random sampling technique was employed to select study participants. Socio-demographic characteristics were collected through interviews. Clinical data were collected by reviewing medical records. Cord blood was collected from the clumped cord. Complete blood count was analyzed by using the Sysmex KX-21 N hematology analyzer. SPSS 20 was used to analyze the data. Bivariable and multivariable binary logistic regression were used to identify associated factors. P-value < 0.05 was considered a statistically significant association. RESULT The median (interquartile range) of cord hemoglobin was 15 g/dL (13.93-16.2 g/dL). From the total, 25% (95% CI: 18.9, 31.1%) of the newborns were anemic. From anemic 89.5, 6.3, and 4.2% were mild, moderate and severe anemia type, respectively. Maternal vegetable consumption habit (AOR = 0.34, 95%CI: 0.17, 0.69) were significant associated with anemia. CONCLUSION Anemia among newborn babies found to be a moderate public health problem. Based on the finding early screening of newborn anemia may reduce further complications.
Collapse
Affiliation(s)
- Tegenaw Tiruneh
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Elias Shiferaw
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Bamlaku Enawgaw
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
20
|
Mikomangwa WP, OMS M, Aklillu E, Kamuhabwa AAR. Adverse birth outcomes among mothers who received intermittent preventive treatment with Sulphadoxine-Pyrimethamine in the low malaria transmission region. BMC Pregnancy Childbirth 2019; 19:236. [PMID: 31286878 PMCID: PMC6615266 DOI: 10.1186/s12884-019-2397-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 07/03/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Malaria in pregnancy increases the risk of adverse birth outcomes such as low birth weight (LBW), maternal and foetal anemia. In Tanzania, some areas have attained low malaria transmission. However, data on the burden of preterm delivery, LBW, maternal and foetal anemia following substantial reduction of malaria transmission in recent years is still scarce in these settings. METHODS A study involving 631 pregnant women was conducted at Mwananyamala referral hospital in Dar es Salaam from April to August, 2018. Study enrollment was done prior to delivery. Structured interview and antenatal clinic cards were used to obtain data including the use of intermittent preventive therapy in pregnancy using sulfadoxine-pyrimethamine (IPTp-SP). Infants birth weights were recorded, maternal venous and cord blood were taken for testing of malaria and determination of haemoglobin (Hb) levels. Chi-square test and regression analysis were done to identify risk factors for preterm delivery, LBW, maternal and foetal anemia. RESULTS The prevalence of malaria among mothers who used at least one dose of IPTp-SP was 0.6% (4/631). Fourteen mothers (2.2%) did not use IPTp-SP and had no malaria infection. The prevalence of maternal anemia, LBW, foetal anemia and preterm delivery was 40.6, 6.5, 5.9 and 9.2% respectively. Participants who were malaria positive had 11 times more risk of LBW compared to those who were negative (AOR, 11; 95%, CI 1.07-132.2; p = 0.04). The risk of delivering babies with LBW was 1.12 times high among mothers who were ≤ 36 weeks of gestation (AOR, 1.12; 95% CI, 0.06-0.25; p = < 0.001). The use of ≥3 doses of IPTp-SP was associated with 83% decrease in risk of LBW compared to those who did not use any dose of IPTp-SP (AOR, 0.17; 95% CI, 0.03-0.88; p = 0.05). Severe anaemia at delivery was associated with seven times increased risk of preterm delivery compared to non-anemic participants (AOR, 6.5; 95% CI, 1.49-28.16; p = 0.013). CONCLUSION Despite the reduced malaria transmission and use of IPTp-SP, prevalence of preterm delivery, maternal anemia, LBW and foetal anemia is still high in Tanzania. The recommended ≥3 doses of IPTp-SP should continue be provided even in areas with substantial reduction of malaria.
Collapse
Affiliation(s)
- Wigilya P. Mikomangwa
- Clinical Pharmacy and Pharmacology Department, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Minzi OMS
- Clinical Pharmacy and Pharmacology Department, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Eleni Aklillu
- Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital-Huddinge C1:68, SE-141 86 Stockholm, Sweden
| | - Appolinary A. R. Kamuhabwa
- Clinical Pharmacy and Pharmacology Department, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| |
Collapse
|
21
|
Kwenti TE. Malaria and HIV coinfection in sub-Saharan Africa: prevalence, impact, and treatment strategies. Res Rep Trop Med 2018; 9:123-136. [PMID: 30100779 PMCID: PMC6067790 DOI: 10.2147/rrtm.s154501] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Malaria and HIV, two of the world's most deadly diseases, are widespread, but their distribution overlaps greatly in sub-Saharan Africa. Consequently, malaria and HIV coinfection (MHC) is common in the region. In this paper, pertinent publications on the prevalence, impact, and treatment strategies of MHC obtained by searching major electronic databases (PubMed, PubMed Central, Google Scholar, ScienceDirect, and Scopus) were reviewed, and it was found that the prevalence of MHC in SSA was 0.7%-47.5% overall. Prevalence was 0.7%-47.5% in nonpregnant adults, 1.2%-27.8% in children, and 0.94%-37% in pregnant women. MHC was associated with an increased frequency of clinical parasitemia and severe malaria, increased parasite and viral load, and impaired immunity to malaria in nonpregnant adults, children, and pregnant women, increased in placental malaria and related outcomes in pregnant women, and impaired antimalarial drug efficacy in nonpregnant adults and pregnant women. Although a few cases of adverse events have been reported in coinfected patients receiving antimalarial and antiretroviral drugs concurrently, available data are very limited and have not prompted major revision in treatment guidelines for both diseases. Artemisinin-based combination therapy and cotrimoxazole are currently the recommended drugs for treatment and prevention of malaria in HIV-infected children and adults. However, concurrent administration of cotrimoxazole and sulfadoxine-pyrimethamine in HIV-infected pregnant women is not recommended, because of high risk of sulfonamide toxicity. Further research is needed to enhance our understanding of the impact of malaria on HIV, drug-drug interactions in patients receiving antimalarials and antiretroviral drugs concomitantly, and the development of newer, safer, and more cost-effective drugs and vaccines to prevent malaria in HIV-infected pregnant women.
Collapse
Affiliation(s)
- Tebit E Kwenti
- Department of Medical Laboratory Sciences, Faculty of Health Sciences, University of Buea,
- Regional Hospital Buea, Buea, Cameroon,
| |
Collapse
|
22
|
Owusu EDA, Djonor SK, Brown CA, Grobusch MP, Mens PF. Plasmodium falciparum diagnostic tools in HIV-positive under-5-year-olds in two ART clinics in Ghana: are there missed infections? Malar J 2018; 17:92. [PMID: 29471833 PMCID: PMC5824602 DOI: 10.1186/s12936-018-2231-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Accepted: 02/13/2018] [Indexed: 12/02/2022] Open
Abstract
Background Plasmodium falciparum, the most dominant species in sub-Saharan Africa, causes the most severe clinical malaria manifestations. In resource-limited Ghana, where malaria and HIV geographically overlap, histidine-rich protein 2 (HRP2)-based rapid diagnostic test (RDT) is a faster, easier and cheaper alternative to clinical gold standard light microscopy. However, mutations in parasite hrp2 gene may result in missed infections, which have severe implications for malaria control. Methods The performance of a common HRP2-based RDT and expert light microscopy in HIV-positive and HIV-negative children under 5 years old was compared with PCR as laboratory gold standard. Finger-prick capillary blood was tested with First Response® Malaria Ag P. falciparum (HRP2). Giemsa-stained thick and thin blood films were examined with ≥ 200 high power fields and parasites counted per 200 white blood cells. Nested PCR species identification of P. falciparum was performed and resolved on agarose gel. False negatives from RDT were further tested for deleted pfhrp2/3 and flanking genes, using PCR. The study was performed in two anti-retroviral therapy clinics in Accra and Atibie. Results Out of 401 participants enrolled, 150 were HIV positive and 251 HIV negative. Malaria was more prevalent in children without HIV. Microscopy had a higher sensitivity [100% (99–100)] than RDT [83% (53.5–100)]. Parasites with pfhrp2/3 deletions contributed to missed infections from RDT false negatives. Conclusion Circulation of malaria parasites with pfrhp2/3 deletions in this population played a role in missed infections with RDT. This ought to be addressed if further strides in malaria control are to be made. Electronic supplementary material The online version of this article (10.1186/s12936-018-2231-7) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Ewurama D A Owusu
- Division of Internal Medicine, Department of Infectious Diseases, Centre of Tropical Medicine and Travel Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands. .,Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, P.O. Box 0s123, Osu, Accra, Ghana.
| | - Samson K Djonor
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, P.O. Box 0s123, Osu, Accra, Ghana
| | - Charles A Brown
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, P.O. Box 0s123, Osu, Accra, Ghana
| | - Martin P Grobusch
- Division of Internal Medicine, Department of Infectious Diseases, Centre of Tropical Medicine and Travel Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.,Centre de Recherches Médicales de Lambaréné (CERMEL), Hôpital Albert Schweitzer, Lambaréné, Gabon.,Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany
| | - Petra F Mens
- Division of Internal Medicine, Department of Infectious Diseases, Centre of Tropical Medicine and Travel Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.,Division of Laboratory Specialisms, Department of Medical Microbiology, Clinical Parasitology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
23
|
Adam I, Salih MM, Mohmmed AA, Rayis DA, Elbashir MI. Pregnant women carrying female fetuses are at higher risk of placental malaria infection. PLoS One 2017; 12:e0182394. [PMID: 28753649 PMCID: PMC5533337 DOI: 10.1371/journal.pone.0182394] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 07/17/2017] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The pathophysiology of the placental malaria is not fully understood. If there is a fetal sex-specific susceptibility to malaria infection, this might add to the previous knowledge on the immunology, endocrinology and pathophysiology of placental malaria infections. AIMS This study was conducted to assess whether the sex of the fetus was associated with placental malaria infections. SUBJECTS AND METHODS A cross-sectional study was performed including a secondary analysis of a cohort of women who were investigated for prevalence and risk factors (including fetal sex) for placental malaria in eastern Sudan. Placental histology was used to diagnose placental malaria infections. RESULTS Among 339 women enrolled, the mean (SD) age was 25.8 (6.7) years and parity was 2.7 (2.2). Among the new born babies, 157 (46.3%) were male and 182 (53.7%) were female. Five (1.5%), 9 (2.7%) and 103 (30.4%) of the 339 placentas had active, active-chronic, past-chronic malaria infection on histopathology examination respectively, while 222 (65.5%) of them showed no malaria infection. Logistic regression analyses showed no associations between maternal age or parity and placental malaria infections. Women who have blood group O (OR = 1.95, 95% CI = 1.19-3.10; P = 0.007) and women who had female new born were at higher risk for placental malaria infections (OR = 2.55, 95% CI = 1.57-4.13; P< 0.001). CONCLUSION Fetal gender may be a novel risk factor for placental malaria. In this work the female placentas were at higher risk for malaria infections than the male placentas.
Collapse
Affiliation(s)
- Ishag Adam
- Faculty of Medicine University of Khartoum, Sudan
| | - Magdi M. Salih
- Faculty of Medical Laboratory Sciences, University of Khartoum, Sudan
| | | | | | | |
Collapse
|
24
|
González R, Rupérez M, Sevene E, Vala A, Maculuve S, Bulo H, Nhacolo A, Mayor A, Aponte JJ, Macete E, Menendez C. Effects of HIV infection on maternal and neonatal health in southern Mozambique: A prospective cohort study after a decade of antiretroviral drugs roll out. PLoS One 2017; 12:e0178134. [PMID: 28575010 PMCID: PMC5456062 DOI: 10.1371/journal.pone.0178134] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 05/08/2017] [Indexed: 12/20/2022] Open
Abstract
Introduction The HIV epidemic is concentrated in sub-Saharan Africa. However, limited information exists on its impact on women and infant’s health since the introduction of antiretroviral drugs in this region, where health resources are often scarce. Methods The effect of HIV infection on maternal health, birth outcomes and infant health was analysed in two contemporary cohorts of HIV-uninfected and HIV-infected pregnant women from southern Mozambique. Pregnant women attending the first antenatal care visit were followed until one month after delivery. Antiretroviral therapy was administered based on CD4+T cell count and clinical stage. Maternal and neonatal morbidity and mortality, as well as pregnancy outcomes were assessed by mother’s HIV status. Results A total of 1183 HIV-uninfected and 561 HIV-infected pregnant women were enrolled. HIV-infected women were more likely to have anaemia both at the first antenatal care visit and at delivery than HIV-uninfected women (71.5% versus 54.8% and 49.4% versus 40.6%, respectively, p<0.001). Incidence of hospital admissions during pregnancy was increased among HIV-infected women (RR, 2.04, [95%CI, 1.45; 2.86]; p<0.001). At delivery, 21% of HIV-infected women reported being on antiretroviral therapy, and 70% having received antiretroviral drugs for prevention of mother to child transmission of HIV. The risk of stillbirths was doubled in HIV-infected women (RR, 2.16 [95%CI 1.17; 3.96], p = 0.013). Foetal anaemia was also increased among infants born to HIV-infected women (10.6% versus 7.3%, p = 0.022). No differences were found in mean birth weight, malaria, prematurity and maternal and neonatal deaths between groups. Conclusions HIV infection continues to be associated with significant maternal morbidity and poor neonatal health outcomes. Efforts should urgently be made to identify the barriers that impede improvements on the devastating effects of HIV in African women and their infants. Trial registration ClinicalTrials.gov NCT 00811421.
Collapse
Affiliation(s)
- Raquel González
- ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
- Manhiça Health Research Center (CISM), Manhiça, Mozambique
- * E-mail:
| | - María Rupérez
- ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
- Manhiça Health Research Center (CISM), Manhiça, Mozambique
| | - Esperança Sevene
- Manhiça Health Research Center (CISM), Manhiça, Mozambique
- Eduardo Mondlane University, Faculty of medicine, Maputo, Mozambique
| | - Anifa Vala
- Manhiça Health Research Center (CISM), Manhiça, Mozambique
| | - Sónia Maculuve
- Manhiça Health Research Center (CISM), Manhiça, Mozambique
| | - Helder Bulo
- Manhiça Health Research Center (CISM), Manhiça, Mozambique
| | | | - Alfredo Mayor
- ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
- Manhiça Health Research Center (CISM), Manhiça, Mozambique
| | - John J. Aponte
- ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
- Manhiça Health Research Center (CISM), Manhiça, Mozambique
| | - Eusébio Macete
- Manhiça Health Research Center (CISM), Manhiça, Mozambique
| | - Clara Menendez
- ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
- Manhiça Health Research Center (CISM), Manhiça, Mozambique
| |
Collapse
|
25
|
Somé EN, Engebretsen IMS, Nagot N, Meda NY, Vallo R, Kankasa C, Tumwine JK, Singata M, Hofmeyr JG, Van de Perre P, Tylleskär T. Changes in body mass index and hemoglobin concentration in breastfeeding women living with HIV with a CD4 count over 350: Results from 4 African countries (The ANRS 12174 trial). PLoS One 2017; 12:e0177259. [PMID: 28486519 PMCID: PMC5423645 DOI: 10.1371/journal.pone.0177259] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 04/25/2017] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Breastfeeding is recommended for infants born to HIV-infected women in low-income settings. Both breastfeeding and HIV-infection are energy demanding. Our objective was to explore how exclusive and predominant breastfeeding changes body mass index (BMI) among breastfeeding HIV1-positive women participating in the ANRS12174 trial (clinical trial no NCT0064026). METHODS HIV-positive women (n = 1 267) with CD4 count >350, intending to breastfeed HIV-negative infants were enrolled from Burkina Faso, South Africa, Uganda and Zambia and counselled on breastfeeding. N = 1 216 were included in the analysis. The trial compared Lamivudine and Lopinavir/Ritonavir as a peri-exposure prophylaxis. We ran a linear mixed-effect model with BMI as the dependent variable and exclusive or predominant breastfeeding duration as the key explanatory variable. RESULTS Any breastfeeding or exclusive/predominant) breastfeeding was initiated by 99.6% and 98.6% of the mothers respectively in the first week after birth. The median (interquartile range: IQR) duration of the group that did any breastfeeding or the group that did exclusive /predominant breastfeeding were 9.5 (7.5; 10.6) and 5.8 (5.6; 5.9)) months, respectively. The median (IQR) age, BMI, CD4 count, and HIV viral load at baseline (day 7) were 27 (23.3; 31) years, 23.7 (21.3; 27.0) kg/m2, 530 (432.5; 668.5) cells/μl and 0.1 (0.8; 13.7)1000 copies/mL, respectively. No major change in mean BMI was seen in this cohort over a 50-week period during lactation. The mean change between 26 and 50 weeks after birth was 0.7 kg/m2. Baseline mean BMI (measured on day 7 postpartum) and CD4 count were positively associated with maternal BMI change, with a mean increase of 1.0 kg/m2 (0.9; 1.0) per each additional baseline-BMI kilogram and 0.3 kg/m2 (0.2; 0.5) for each additional CD4 cell/μl, respectively. CONCLUSION Breastfeeding was not negatively correlated with the BMI of HIV-1 infected Sub-Saharan African mothers. However, a higher baseline BMI and a CD4 count >500 cells/μl were associated with maternal BMI during the exclusive/ predominant breastfeeding period. Considering the benefits of breast milk for the infants and the recurrent results from different studies that breastfeeding is not harmful to the HIV-1-infected mothers, this study also supports the WHO 2016 guidelines on infant feeding that mothers living with HIV should breastfeed where formula is not safe for at least 12 months and up to 24 months, given that the right treatment or prophylaxis for the infection is administered. These findings and conclusions cannot be extrapolated to women who are immune-compromised or have AIDS.
Collapse
Affiliation(s)
- Eric Nagaonlé Somé
- Centre for International Health, University of Bergen, Bergen, Norway
- National Health Research Institute, Centre National pour la Recherche Scientifique et Technologique, Ouagadougou, Burkina Faso
| | | | - Nicolas Nagot
- INSERM UMR 1058, Pathogenesis and control of chronic infections, Montpellier, France
- Université de Montpellier, Montpellier, France
- Centre Hospitalier Universitaire, Montpellier, France
| | - Nicolas Y. Meda
- University of Ouagadougou, Faculty of Health Sciences, Centre de Recherche International en Santé (CRIS) Ouagadougou, Burkina Faso
| | - Roselyne Vallo
- INSERM UMR 1058, Pathogenesis and control of chronic infections, Montpellier, France
- Université de Montpellier, Montpellier, France
| | - Chipepo Kankasa
- University of Zambia, School of Medicine, Department of Paediatrics and Child Health, University Teaching Hospital, Lusaka, Zambia
| | - James K. Tumwine
- Makerere University, Department of Paediatrics and Child Health, School of Medicine, College of Health Sciences, Kampala, Uganda
| | - Mandisa Singata
- University of Fort Hare, Effective Care Research Unit, Eastern Cape, South Africa
| | - Justus G. Hofmeyr
- University of Fort Hare, Effective Care Research Unit, Eastern Cape, South Africa
| | - Philippe Van de Perre
- INSERM UMR 1058, Pathogenesis and control of chronic infections, Montpellier, France
- Université de Montpellier, Montpellier, France
- Centre Hospitalier Universitaire, Montpellier, France
| | | | | |
Collapse
|
26
|
Eki-Udoko FE, Sadoh AE, Ibadin MO, Omoigberale AI. Prevalence of congenital malaria in newborns of mothers co-infected with HIV and malaria in Benin city. Infect Dis (Lond) 2017; 49:609-616. [PMID: 28399686 DOI: 10.1080/23744235.2017.1312667] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND HIV and Plasmodium falciparum malaria co-infection annually complicates about one million pregnancies in sub-Saharan Africa. Congenital malaria (CM) has deleterious effects on newborns. Little is known about the effect of co-infections on the prevalence of CM in infants born by these women. This study was carried out to determine the prevalence of CM in newborns of mothers co-infected with HIV and malaria compared to HIV-negative mothers with malaria in Benin-City. METHODS Subjects were 162 newborns of mothers co-infected with HIV and malaria. Controls were 162 newborns of HIV negative malaria infected mothers. Blood film for malaria parasites was done on cord blood and peripheral blood on days 1, 3 and 7 in the newborns. Maternal peripheral blood film for malaria parasite was done at delivery and placental tissue was obtained for confirmation of placental malaria by histology. Diagnosis of malaria in blood films was by light microscopy. RESULTS The prevalence of CM in subjects was significantly higher than in controls (34.6% and 22.2%, p=.014). Profound immunodepression (maternal CD4 cell count <200 cell/mm3) was significantly associated with CM (p=.006). The major predictors of CM in subjects were maternal CD4 cell count <200 cell/mm3 and placental malaria while in controls placental malaria was the only predictor. CONCLUSIONS Babies born to mothers co-infected with HIV and malaria are at increased risk for CM. All babies born by HIV positive mothers should be screened for CM.
Collapse
Affiliation(s)
| | - Ayebo E Sadoh
- a Department of Child Health , University of Benin Teaching Hospital , Benin-City , Nigeria
| | - Michael O Ibadin
- a Department of Child Health , University of Benin Teaching Hospital , Benin-City , Nigeria
| | | |
Collapse
|
27
|
Naing C, Sandhu NK, Wai VN. The Effect of Malaria and HIV Co-Infection on Anemia: A Meta-Analysis. Medicine (Baltimore) 2016; 95:e3205. [PMID: 27057848 PMCID: PMC4998764 DOI: 10.1097/md.0000000000003205] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Revised: 03/02/2016] [Accepted: 03/07/2016] [Indexed: 01/03/2023] Open
Abstract
Malaria and human immunodeficiency virus (HIV) infections are globally important public health concerns. The objectives of this study were (i) to determine the prevalence of malaria and HIV co-infections in people living in endemic countries, and (ii) to assess the effect of co-infection on anemia.Studies were searched on electronic databases including PubMed, Embase, Medline, Google Scholar, and African Journals Online. Observational studies, assessing the prevalence of co-infection and reporting its association with anemia, were included. The methodological quality of included studies was assessed using a tool called the risk of bias assessment for non-randomized studies. Heterogeneity among studies was investigated with the I-square test. Pooled prevalence of the co-infection and its 95% confidence interval (CI) were estimated using the random-effect model, reflected on heterogeneity among studies. Summary odds ratio (OR), summary standardized mean difference (SMD), and their corresponding 95% CIs were estimated, as appropriate. Subgroup analysis and meta-regression were performed for robustness of results. Publication bias was assessed by visualization of a funnel plot.Twenty-three studies were included in the present study. Overall, the pooled prevalence of co-infection was 19% (95% CI: 15-23%, I: 98.1%), showing 26% (95% CI: 20-32%, I: 98.7%) in adults, 12% (95% CI: 7-17%, I: 95.0) in pregnant women, and 9% (95% CI: 6-11%, I: 68.6%) in children. Anemia was comparable between the monoinfected and co-infected adults (summary OR: 1.49, 95% CI: 0.93-2.37) and increased by 49% in co-infected pregnant women (summary OR: 1.49, 95% CI: 1.14-1.94). The mean hemoglobin concentration was significantly lower in the co-infected group than the monoinfected group (summary SMD: -0.47, 95% CI: -0.61 to -0.33). The results of meta-regression on the prevalence of co-infection using the publication year and total population as covariates showed the I value remained high implying a de facto random distribution of heterogeneity. An asymmetrical funnel plot indicated the presence of publication bias. Due to heterogeneity of the studies in this review, the results have to be interpreted with caution.The findings of this study suggest that the prevalence of malaria and HIV co-infection, particularly in pregnant women, requires special attention from healthcare personnel. Better understanding of the co-infection is crucial for designing treatment strategies. Future well-powered, prospective designs assessing the interaction between malaria and HIV are recommended.
Collapse
Affiliation(s)
- Cho Naing
- From the School of Postgraduate Studies (CN, NKS); and School of Medicine (VNW), International Medical University, Kuala Lumpur, Malaysia
| | | | | |
Collapse
|
28
|
Wumba RD, Zanga J, Aloni MN, Mbanzulu K, Kahindo A, Mandina MN, Ekila MB, Mouri O, Kendjo E. Interactions between malaria and HIV infections in pregnant women: a first report of the magnitude, clinical and laboratory features, and predictive factors in Kinshasa, the Democratic Republic of Congo. Malar J 2015; 14:82. [PMID: 25884992 PMCID: PMC4336768 DOI: 10.1186/s12936-015-0598-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2014] [Accepted: 01/30/2015] [Indexed: 11/12/2022] Open
Abstract
Background HIV and malaria are among the leading causes of morbidity and mortality during pregnancy in Africa. However, data from Congolese pregnant women are lacking. The aim of the study was to determine the magnitude, predictive factors, clinical, biologic and anthropometric consequences of malaria infection, HIV infection, and interactions between malaria and HIV infections in pregnant women. Methods A cross-sectional study was conducted among pregnant women admitted and followed up at Camp Kokolo Military Hospital from 2009 to 2012 in Kinshasa, the Democratic Republic of Congo. Differences in means between malaria-positive and malaria-negative cases or between HIV-positive and HIV-negative cases were compared using the Student’s t-test or a non-parametric test, if appropriate. Categorical variables were compared using the Chi-square or Fisher’s exact test, if appropriate. Backward multivariable analysis was used to evaluate the potential risk factors of malaria and HIV infections. The odds ratios with their 95% confidence interval (95% CI) were estimated to measure the strengths of the associations. Analyses resulting in values of P < 0.05 were considered significant. Results A malaria infection was detected in 246/332 (74.1%) pregnant women, and 31.9% were anaemic. Overall, 7.5% (25/332) of mothers were infected by HIV, with a median CD4 count of 375 (191; 669) cells/μL. The mean (±SD) birth weight was 2,613 ± 227 g, with 35.7% of newborns weighing less than 2,500 g (low birth weight). Low birth weight, parity and occupation were significantly different between malaria-infected and uninfected women in adjusted models. However, fever, anemia, placenta previa, marital status and district of residence were significantly associated to HIV infection. Conclusion The prevalence of malaria infection was high in pregnant women attending the antenatal facilities or hospitalized and increased when associated with HIV infection.
Collapse
Affiliation(s)
- Roger D Wumba
- Department of Tropical Medicine, Infectious and Parasitic Diseases, Department of Parasitology, University Clinic of Kinshasa, Faculty of Medicine, University of Kinshasa, Kinshasa, Congo.
| | - Josué Zanga
- Department of Tropical Medicine, Infectious and Parasitic Diseases, Department of Parasitology, University Clinic of Kinshasa, Faculty of Medicine, University of Kinshasa, Kinshasa, Congo.
| | - Michel N Aloni
- Department of Pediatrics, University Hospital of Kinshasa, Faculty of Medicine, University of Kinshas, Kinshasa, the Democratic Republic of Congo.
| | - Kennedy Mbanzulu
- Department of Tropical Medicine, Infectious and Parasitic Diseases, Department of Parasitology, University Clinic of Kinshasa, Faculty of Medicine, University of Kinshasa, Kinshasa, Congo.
| | - Aimé Kahindo
- Department of Tropical Medicine, Infectious and Parasitic Diseases, Department of Parasitology, University Clinic of Kinshasa, Faculty of Medicine, University of Kinshasa, Kinshasa, Congo.
| | - Madone N Mandina
- Department of Internal Medicine, University Hospital of Kinshasa, Faculty of Medicine, University of Kinshasa, Kinshasa, the Democratic Republic of Congo.
| | - Mathilde B Ekila
- Department of Internal Medicine, University Hospital of Kinshasa, Faculty of Medicine, University of Kinshasa, Kinshasa, the Democratic Republic of Congo.
| | - Oussama Mouri
- Centre Nationale de Référence du Paludisme, AP-HP, CHU Pitie Salpêtrière-Charles Foix, 47, boulevard de l'Hôpital, 75651, Paris, Cedex 13, France. .,Laboratory of Parasitology and Mycology, Pitié Salpêtrière Hospital, Public Assistance-Hospitals of Paris, Pierre and Marie Curie University, Paris, France.
| | - Eric Kendjo
- Centre Nationale de Référence du Paludisme, AP-HP, CHU Pitie Salpêtrière-Charles Foix, 47, boulevard de l'Hôpital, 75651, Paris, Cedex 13, France. .,Laboratory of Parasitology and Mycology, Pitié Salpêtrière Hospital, Public Assistance-Hospitals of Paris, Pierre and Marie Curie University, Paris, France. .,Department of Parasitology, Mycology and Tropical Medicine, Faculty of Medicine, University of Health Sciences, Libreville, Gabon. .,Institute of Tropical Medicine, University of Tubingen, Tubingen, Germany.
| |
Collapse
|
29
|
Mother-to-Children Plasmodium falciparum Asymptomatic Malaria Transmission at Saint Camille Medical Centre in Ouagadougou, Burkina Faso. Malar Res Treat 2014; 2014:390513. [PMID: 25506464 PMCID: PMC4259075 DOI: 10.1155/2014/390513] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Accepted: 11/01/2014] [Indexed: 12/04/2022] Open
Abstract
Background. Malaria's prevalence during pregnancy varies widely in parts of sub-Saharan Africa, including Burkina Faso. The objective of this study was to evaluate the incidence of mother-to-child malaria transmission during childbirth at St. Camille Medical Centre in the city of Ouagadougou. Methods. Two hundred and thirty-eight (238) women and their newborns were included in the study. Women consenting to participate in this study responded to a questionnaire that identified their demographic characteristics. Asymptomatic malaria infection was assessed by rapid detection test Acon (Acon Malaria Pf, San Diego, USA) and by microscopic examination of Giemsa-stained thick and thin smears from peripheral, placental, and umbilical cord blood. Birth weights were recorded and the biological analyses of mothers and newborns' blood were also performed. Results. The utilization of long-lasting insecticidal nets (LLINs) and intermittent preventive treatment with sulfadoxine-pyrimethamine (SP) were 86.6% and 84.4%, respectively. The parasitic infection rates of 9.5%, 8.9%, and 2.8% were recorded, respectively, for the peripheral, placental, and umbilical cord blood. Placental infection was strongly associated with the presence of parasites in the maternal peripheral blood and a parasite density of >1000 parasites/µL. Conclusion. The prevalence of congenital malaria was reduced but was associated with a high rate of mother-to-child malaria transmission.
Collapse
|